Improving access to treatments in the community for trauma and medical emergencies, and ketamine for palliative care from 1 March 2026

We are writing to inform you that from 1 March 2026, the following treatments will be available in the community via listing in Section B of the Pharmaceutical schedule:

For Primary Response in Medical Emergencies PRIME services

• Droperidol inj 2.5 mg per ml (1 ml ampoule)

• Glucose inj 5% (100 ml bag)

• Glucose inj 10% (500 ml bag)

• Ketamine inj 100 mg per ml (2 ml vial)

• Methoxyflurane solution for inhalation 999 mg per g (3 ml bottle and plastic inhaler, and 3 ml bottles)

• Tranexamic acid inj 100 mg per ml (10 ml ampoule)

• Enoxaparin inj 100 ml per ml (1 ml syringe)

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These treatments will be funded on a Practitioner Supply Order (PSO) with an endorsement limiting funding to PRIME indications.

Ketamine for intractable pain in people receiving palliative care

Ketamine inj 100mg/ml (2ml vial) will be also listed in Section B of the Pharmaceutical Schedule for the treatment of intractable pain in people receiving palliative care in community settings, including hospices, rest homes, and for people living at home.  Practitioners will no longer need to apply for funding through the Named Patient Pharmaceutical Assessment (NPPA) exceptional circumstances pathway for this indication.

Ketamine injection does not have Medsafe approval for subcutaneous administration or for intractable pain in palliative care. It must be prescribed and used in accordance with section 25 of the Medicines Act 1981 (external link).

The Australia New Zealand Society of Palliative Medicine (ANZSPM) and Hospice NZ have published Aotearoa Specialist Adult Palliative Care guidelines  which provide clinical guidance regarding the use of ketamine for intractable pain for people receiving palliative care (monograph page 157, protocol page 194). There is also a short section on ketamine in the associated Palliative Care Handbook (page 133). These documents are intended for professionals working in specialist palliative care in Aotearoa only.

Tranexamic acid for the treatment of post-partum haemorrhage

Tranexamic acid inj 100mg/ml will also be listed via the Practitioner Supply Order (PSO) mechanism for the treatment of postpartum haemorrhage.

Health New Zealand publishes current guidelines for the prevention and management of Post Partum Haemorrhage which include the use of tranexamic acid; available here 

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Please share this information with your colleagues and within your networks.

Questions:

If you have any queries, please contact us at enquiry@pharmac.govt.nz.

Ngā mihi

Dr David Hughes

Chief Medical Officer | Director Advice & Assessment

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Pharmac | Te Pātaka Whaioranga | PO Box 10 254 | Level 9, 40 Mercer Street, Wellington

DDI: +64 21 962 317 | P: +64 4 460 4990 |  www.pharmac.govt.nz